NEHA October 2024 Journal of Environmental Health

ADVANCEMENT OF THE SCIENCE

tory disease agenda. Traditionally, the focus was on prevention only (via interventions and exposure reduction), early disease iden- tification (via health surveillance), and com- pensation. Today, with older adults staying in the workforce longer, some of these workers have already developed work- or nonwork- related respiratory diseases; thus, the focus should also shift toward helping people to work up until they choose to retire—and to be as healthy and fit as possible. This shift means that healthcare professionals (in particular respiratory physicians) need to have more knowledge about the interaction between disease and the work environment, as well as which factors in the work environ- ment can lead to the deterioration of respira- tory diseases even when they are not work- related (De Matteis et al., 2017). Changes in the Workforce and Labor Participation A rapid growth in life expectancy is a great demonstration of the successes in preven- tion and care in achieving healthy aging. In response to aging societies, many countries

have enacted policies to increase labor force participation among older adult workers and to counteract the adverse consequences of diseases for labor force participation. A clear need exists for research to develop strategies to support the ability of older individuals with chronic diseases to work (De Matteis et al., 2017). Work-related disability is one of the most important routes of displacement from the labor market. A systematic review found that workers with respiratory disease at enrollment across 5 longitudinal studies had a 2.4 times higher risk of disability pen- sion during the follow-up period (van Rijn et al., 2014). Conclusion Most occupational lung diseases have long latency periods, with workers manifesting diseases long after exposure. Most of these diseases are associated with devastating lung damage that has no cure. Age is a major fac- tor, as it is in most diseases, but the e‰ect becomes more apparent in occupational lung diseases due to the long latency periods of these conditions. Furthermore, age is associ-

ated with cellular, structural, functional, and immunological changes in the lung, increas- ing one’s susceptibility to exposure-induced lung injuries and chronic lung diseases such as occupational lung diseases. As we report in this review, mortality asso- ciated with most occupational lung diseases peaked at an age lower than that of the U.S. mortality rate for all diseases, indicating the potential e‰ect of age on the disease outcome. Prevention from exposure, disease surveil- lance programs, and upholding industrial standards for exposures at work are essential ways of reducing the burden associated with preventable occupational lung diseases. Lastly, continuing research to better understand the e‰ect of age on these occupational exposures will help provide a safer environment for all workers, especially older adults who are stay- ing in the workforce for longer. Corresponding Author: Alexander C. Ufelle, Associate Professor and Chair, Department of Public Health Sciences, Slippery Rock Uni- versity, 1 Morrow Way, Slippery Rock, PA 16057. Email: alexander.ufelle@sru.edu

References

Akgun, M. (2018). Pneumoconiosis . https://doi.org/10.1093/obo/ 9780199756797-0187 American Lung Association. (2024). Asbestosis . https://www.lung. org/lung-health-diseases/lung-disease-lookup/asbestosis Anecchino, C., Rossi, E., Fanizza, C., De Rosa, M., Tognoni, G., Romero, M., & Working Group ARNO Project. (2007). Prevalence of chronic obstructive pulmonary disease and pattern of comor- bidities in a general population. International Journal of Chronic Obstructive Pulmonary Disease , 2 (4), 567–574. Asbestos: Medical Surveillance Guidelines for Asbestos Non-Man- datory (Appendix H), 29 C.F.R. § 1910.1001 (2024). https:// www.ecfr.gov/current/title-29/subtitle-B/chapter-XVII/part-1910/ subpart-Z/section-1910.1001 Barber, C., & Fishwick, D. (2020). Pneumoconiosis. Medicine , 48 (6), 417–421. https://doi.org/10.1016/j.mpmed.2020.03.012 Barnes, H., Troy, L., Lee, C.T., Sperling, A.I., Strek, M.E., & Glaspole, I. (2022). Hypersensitivity pneumonitis: Current concepts in pathogenesis, diagnosis, and treatment. Allergy , 77 (2), 442–453. https://doi.org/10.1111/all.15017 Bhandari, J., Thada, P.K., & Sedhai, Y.R. (2022). Asbestosis. In StatPearls . StatPearls Publishing. http://www.ncbi.nlm.nih.gov/ pubmed/32310445

Brandenberger, C., & Mühlfeld, C. (2017). Mechanisms of lung aging. Cell and Tissue Research , 367 (3), 469–480. https://doi. org/10.1007/s00441-016-2511-x Budinger, G.R.S., Kohanski, R.A., Gan, W., Kobor, M.S., Amaral, L.A., Armanios, M., Kelsey, K.T., Pardo, A., Tuder, R., Macian, F., Chandel, N., Vaughan, D., Rojas, M., Mora, A.L., Kovacs, E., Dun- can, S.R., Finkel, T., Choi, A., Eickelberg, O., . . . Thannickal, V.J. (2017). The intersection of aging biology and the pathobiology of lung diseases: A joint NHLBI/NIA workshop. The Journals of Ger- ontology: Series A , 72 (11), 1492–1500. https://doi.org/10.1093/ gerona/glx090 Centers for Disease Control and Prevention. (1983). Leading work- related diseases and injuries—United States. Morbidity and Mor- tality Weekly Report , 32 (2), 24–26, 32. https://www.cdc.gov/ mmwr/preview/mmwrhtml/00001234.htm Chatila, W.M., Thomashow, B.M., Minai, O.A., Criner, G.J., & Make, B.J. (2008). Comorbidities in chronic obstructive pulmonary dis- ease. Proceedings of the American Thoracic Society , 5 (4), 549–555. https://doi.org/10.1513/pats.200709-148ET Cho, S.J., & Stout-Delgado, H.W. (2020). Aging and lung dis- ease. Annual Review of Physiology , 82 (1), 433–459. https://doi. org/10.1146/annurev-physiol-021119-034610

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Volume 87 • Number 3

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